Primary Bank, which celebrated its grand opening Friday as the first new New Hampshire bank in seven years, expects to build three additional branches and reach at least $300 million in assets in the...

NH's largest two hospitals looking to collaborate

MANCHESTER - The heads of the two largest New Hampshire health care organizations said Wednesday they have begun a dialogue on how to collaborate to deliver better health care to New Hampshire residents at a lower cost.

Dartmouth-Hitchcock and Elliot Health System this week let their workers know that a "good-faith dialogue" had been started and that collaborations were necessary as new models of health care develop. Representatives arranged a conference call with the New Hampshire Union Leader after a reporter contacted them.

Elliot President and Chief Executive Officer Douglas Dean said the talks will help establish a better tone for delivery of health care in the state.

"We're focused on the reality that health care costs are getting out of the realm of affordability for state government, federal government and the business community," Dean said.

"There is much to be considered and much to be decided as we move forward," Dr. James Weinstein, president and chief executive officer of Dartmouth-Hitchcock, told employees in a memo dated Tuesday. "One point should be made clear, though: these discussions are not about a merger, an acquisition or a takeover."

In 2008, Dartmouth-Hitchcock and Catholic Medical Center launched efforts toward a so-called affiliation, a proposal rejected two years later by Attorney General Michael Delaney. He said the deal amounted to an acquisition of CMC by the larger organization.

The Lebanon-based Dartmouth-Hitchcock is the largest health care provider in the state. It encompasses a medical school, a 396-bed hospital in Lebanon, a Level 1 trauma care center at the hospital and a network of 900 physicians in New Hampshire and Vermont, including a multi-specialty physician practice in Manchester.

Elliot Hospital's primary care network counts about 120,000 patients in its network. The hospital had admissions of about 13,000 a year, and its emergency room and two urgent care centers experience 125,000 visits a year.

Dean said the talks would concentrate on the Elliot service area, which includes Manchester and southern New Hampshire. Talks also involve the two hospitals' pediatric hospitals, which have a broader reach. Weinstein said in the new world of health care, the focus is on how to manage care for the population, "to think of value, not volumes; to think of populations, not market share."

Dean said the discussions will involve himself, Weinstein, senior management, physicians and board members of both institutions.

Weinstein said the discussions do not mean that Dartmouth-Hitchcock has abandoned a close working relationship with CMC. In 2010, both institutions said they would maintain close ties despite the rejection of the potential affiliation.

"We're still working with CMC. We're looking to take care of the population with another great partner, Elliot Hospital," Weinstein said.

In 2010, Dartmouth-Hitchcock helped form a collaborative between the Mayo Clinic, Denver Clinic, Cleveland Clinic and other organizations to identify and disseminate best-care practices for nine high-cost, common physical illnesses. The High Value Healthcare Collaborative has since grown to encompass 22 institutions with a patient population of 50 million.

"If I can do this across the country," Weinstein said, "Doug and I ought to be able to do this with (CMC President) Joe (Pepe) and anybody else for our state."